鼻咽癌常规放疗与调强放疗的不良反应比较

Comparison of side effects of intensity modulated radiotherapy and conventional radiotherapy in nasopharyngeal carcinoma

目的:比较鼻咽癌调强放疗和常规放疗的不良反应。方法:118例鼻咽癌患者,调强放疗组61例、常规放疗组57例,调强放疗组靶区为鼻咽肿瘤、咽旁间隙和颈部淋巴区,分次剂量为2.0～2.5 Gy/次,33次;常规组用面颈联合野照射DT40～60 Gy/(20～30次.4～6周),耳前野补量至鼻咽区DT70 Gy;颈部预防总量为DT50～55 Gy。结果:调强组和常规组1年口干发生率分别为8.20%(5/61)和94.73%(54/57),张口困难发生率分别为4.92%(3/61)和71.93%(41/57),两组比较,差异均有显著性(P<0.01)。结论:鼻咽癌调强放疗比常规放疗的不良反应明显降低。

Objective ：To compare the side effects of intensity modulated radiotherapy （IMRT） and conventional radiotherapy in nasopharyngeal carcinoma. Methods：Among 118 cases of nasopharyngeal carcinoma, there were 61 of IMRT and 57 of conventional radiotherapy. The target areas in IMRT were nasopharyngeal carcinoma, parapharyngeal space and neck lymphatic area with the fractional dose of 2.0-2.5 Gy/time, for 33 times. The conventional radiotherapy group was given face-neck joint radiation, DT 40-60 Gy, 20-30 times for 4-6 weeks. The reinforcing dosage in pre-auricular field increased to DT 70 GY in the nasopharyngeal area. The total amount of neck prevention was DT 50-55 Gy.Results：The 1-year dry mouth incidence in the IMRT and conventional radiotherapy groups was 8.20% （5/ 61） and 94.73%（54/%57） respectively, the incidence of difficulty in opening mouth in the IMRT and conventional radiotherapy groups was 4.92%（3/61） and 71.93%（41/57） respectively. There was significant difference between the two groups （P〈0.01）. Conclusion：IMRT decreases obviously the side effects compared with the conventional radiotherapy.